Nursing Elites

1. A nurse is reviewing the client population of a local community health center and identifying the health care needs of the group. The nurse decides to develop a screening program for hypertension. Which client population would the nurse most likely be working with?

• A. A seniors' group based at a Jewish community center.
• B. A Native American reservation/Canadian aboriginal reserve.
• C. A predominantly Chinese-American neighborhood.
• D. A minimum-security prison serving young, rehabilitating offenders.

Correct answer: B

Rationale: Hypertension is disproportionately high among Native American/First Nations clients. This condition is not noted to be a major health problem among Jewish Americans, prisoners, or Americans of Chinese ancestry. Developing a screening program for hypertension in a Native American reservation/Canadian aboriginal reserve would be most appropriate based on the prevalence of the condition in this population.

2. A gerontological nurse is providing care at a local community health center that serves large black American and white American older adult populations. The nurse is working to develop culturally appropriate programs to meet each group's health needs and notes differences in health status between the groups. Which reason would the nurse most likely identify as accounting for the differences between the populations?

• A. High incidence of violent crime and sexually transmitted diseases in the black population
• B. Reliance on family for health care advice and rejection of formal service agencies in the white population
• C. Cultural preference for unconventional medical treatments like herbal remedies in the white population
• D. Lower standard of living and less access to health care services in the black population

Correct answer: D

Rationale: The correct answer is D. Black older adults historically possess many health problems that have accumulated over a lifetime due to a poor standard of living and limited access to health care services. Option A is incorrect because it presents stereotypes about the black population that are not supported by evidence. Option B is incorrect because it generalizes the behavior of the white population without a strong basis. Option C is incorrect as it also generalizes the white population and does not address the disparities in health status between the two groups.

3. A 52-year-old woman is preparing to have her father move into her home after his discharge from the hospital. Which of the following subjects should the discharge planning nurse prioritize when preparing the woman for her new caregiving role?

• A. The availability and scope of community resources
• B. The importance of her own self-care and techniques for maximizing it
• C. Assertiveness training to ensure she can set limits
• D. Management of finances

Correct answer: B

Rationale: The correct answer is B. It is crucial for the discharge planning nurse to prioritize the importance of the woman's self-care and provide techniques for maximizing it. When taking on a caregiving role, the caregiver's well-being is essential to ensure effective care for the patient. While community resources (choice A) are important, the immediate focus should be on self-care. Assertiveness training (choice C) and financial management (choice D) are also significant but not as critical as self-care for the caregiver in this scenario.

4. An 81-year-old female client has presented to the emergency department accompanied by her daughter with whom she lives. The daughter states that her mother has experienced a recent series of falls, which have resulted in her facial and arm bruises. The client smells of urine and is noticeably emaciated, unkempt, and anxious while the daughter berates her during the nurse's assessment. What is the nurse's responsibility in this situation?

• A. Determine the daughter's legal status with regard to her mother's financial affairs
• B. Report suspected elder abuse
• C. Establish whether the client has a durable power of attorney in place
• D. Obtain medical records regarding prior admissions for similar problems

Correct answer: B

Rationale: In cases of suspected elder abuse, the nurse is responsible for reporting his or her suspicions to the relevant authorities. In this scenario, the signs of elder abuse are evident, such as the client's bruises, unkempt appearance, and the daughter's behavior. Determining the daughter's legal status or the client's power of attorney are not immediate priorities when abuse is suspected. Obtaining medical records for prior admissions is also not the primary concern in this situation.

5. An 81-year-old female client was diagnosed one year ago with Alzheimer's disease following a noticeable increase in confusion. She now possesses a durable power of attorney. Which of the following statements most accurately conveys an aspect of this legal arrangement?

• A. The parameters of the arrangement must be revisited if the client's condition declines.
• B. The arrangement was most likely initiated by court order.
• C. The client appointed someone to take care of her affairs in the event that she becomes incompetent.
• D. The family has control of logistical arrangements for the client but must gain court permission around financial affairs.

Correct answer: C

Rationale: The correct answer is C. Usually, a power of attorney becomes invalid if the individual granting it becomes incompetent, except in the case of a durable power of attorney. A durable power of attorney allows competent individuals to appoint someone to make decisions on their behalf in the event that they become incompetent. This legal arrangement is recommended for individuals with conditions like Alzheimer's disease where competency decline can be anticipated. It is not initiated by the court, unlike guardianship. A durable power of attorney encompasses both logistical and financial affairs, providing authority to the appointed person to act on behalf of the individual should they become incapacitated. Choices A, B, and D are incorrect because they do not accurately describe the purpose and nature of a durable power of attorney in the context of planning for incompetency due to conditions like Alzheimer's disease.

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